Beyzadeoglu, T. | Köse, G.T. | Ekici, I.D. | Bekler, H. | Yilmaz, C.

Erratum | 2012 | Acta Orthopaedica et Traumatologica Turcica46 ( 4 )

[No abstract available]

Sever, C. | Uygur, F. | Külahçi, Y. | Torun Köse, G. | Urhan, M. | Küçükodaci, Z. | Çayci, T.

Article | 2010 | Acta Orthopaedica et Traumatologica Turcica44 ( 5 ) , pp.403 - 409

Objectives: This experimental study aimed to create a prefabricated vascularized bone graft using the interconnected porous coralline hydroxyapatite ceramic by combining vascular bundle implantation, mesenchymal stem cells, and hyperbaric oxygen therapy (HBOT) administration in a rat model. Methods: Forty-five male Sprague-Dawley rats were divided into three groups, each containing 15 rats. The hydroxyapatite ceramics were vascularized by the superficial inferior epigastric artery and vein in all groups. These vessels passed through the hole of the hydroxyapatite blocks. In Group 2, mesenchymal stem cells were administered into the . . .hydroxyapatite. In Group 3, both mesenchymal stem cells and HBOT were administered. The presence and density of any new bone formation and neovascularization were evaluated by radiography, microangiography, scintigraphy, biochemical analysis, and histomorphometry. Results: Neovascularization and bone formation were significantly greater in Group 3, in which both mesenchymal stem cells and HBOT were applied, than the other groups. Conclusion: HBOT enhances neovascularization and osteogenesis, thus HBOT can provide optimal and faster prefabrication of a vascularized bone graft. © 2010 Turkish Association of Orthopaedics and Traumatology Daha fazlası Daha az

Özkul, F. | Erol Barkana, D. | Badilli Demirbaş, Ş. | Inal, S.

Article | 2012 | Acta Orthopaedica et Traumatologica Turcica46 ( 05.06.2020 ) , pp.332 - 338

Objective: The aim of this study was to evaluate the proprioceptive sense of elbow flexion through a robot-assisted rehabilitation system, RehabRoby, and to understand the usability of RehabRoby as a robotic system in physiotherapy. Methods: The study included 20 volunteer, healthy students studying either physiotherapy (PT) (5 females and 5 males) or electrical and electronics engineering (EEE) (5 females and 5 males). Using the RehabRoby, they were asked to flex their elbow joints in pronation actively and then against a comfortable resistance to the target angles (20°, 45° and 90°), with eyes open and closed. Angle of movement an . . .d applied torque for each target angle and error of movement with respect to the target angle (error of matching) were recorded as absolute values. Participants' socio-demographic and physical features were also evaluated. Results: Physiotherapy students had less matching error at 45° with eyes opened than EEE students. A negative correlation was found between resistive elbow flexion and applied torque while eyes closed at 20° ( Daha fazlası Daha az

Bekler, H. | Bulut, G. | Usta, M. | Gokce, A. | Okyar, F. | Beyzadeoglu, T.

Article | 2008 | Acta Orthopaedica et Traumatologica Turcica42 ( 2 ) , pp.125 - 129

Objectives: This experimental study was designed to find new ways of improving stabilization of fractures in osteoporotic elderly patients through alterations made in the configuration and geometry of locked screw-plate fixation used in the conventional plate technique. Methods: Four screw configurations with varying angulations were used for plate-bone construction. Forty iron plates of high quality (100×35×3 mm) were divided into four groups and two screw holes, 3 mm in diameter, were drilled on each plate at a distance of 15 mm. In group A, the holes were drilled so that the screws would be vertically sent to the bone interface. . . .In the remaining groups, the holes were drilled for convergent (group B, 15°) and divergent (group C, 15°; group D, 30°) screw orientation. Screw-plate fixation was tested in a modified osteoporotic bone (Osteoporotic Generic Bone, Synbone) on an Instron materials testing system with an axial pullout force of 0.1 mm/sec. Failure loads were read from load-displacement curves and the type of failure was noted. Results: Screws placed in divergent orientations showed the highest axial pull-out strength (group C, 83.3 N/mm; group D, 80.8 N/mm), followed by convergent placement (72N/mm) and vertical placement (66.7 N/ mm). The type of failure was breakage of the bone sample in divergent configurations, and screw pull-out in convergent and vertical configurations. Conclusion: Divergent constructs may be a promising alternative to conventional screw placement in treating osteoporotic fractures. ©2008 Turkish Association of Orthopaedics and Traumatology Daha fazlası Daha az

Çakmak, Selami | Mahiroğulları, Mahir | Keklikçi, Kenan | Sarı, Enes | Erdik, Baran | Rodop, Osman

Article | 2013 | Acta Orthopaedica et Traumatologica Turcica47 ( 3 ) , pp.162 - 172

Amaç: Bu makale ile bilateral, bifosfonatla ilişkili, düşük enerjili femur cisim kırığı olan hastaların demografik özelliklerinin değerlendirilmesi amaçlandı. Çalışma planı: Ocak 2008 ila Ocak 2012 tarihleri arasında düşük enerjili femur cisim kırığı olan hastaların kayıtları incelenerek bifosfonatla ilişkili olabilecek olgular saptandı. Postmenopozal osteoporoz tanısı olan, en az 5 yıl süreyle bifosfonat kullanan ve kırıkları öncesinde prodromal ağrısı olan hastalar çalışmaya alındı. Bulgular: Çalışmaya alınma kriterlerine uyan 5 kadın hasta saptandı. Hastaların hepsinde bilateral, düşük enerjili, ardışık femur cisim kırığı vardı. . . .Kırık yapıları benzerdi ve atipik (lateral kortekste kalınlaşmanın olduğu transvers-kısa oblik kırıklar) idi. Ortalama bifosfonat tedavi süresi 8.6 yıl idi. Ortalama hasta yaşı 76.2 olarak saptandı. Üç hastanın ortalama kırık kaynama süresi 20-28 hafta idi. Diğer iki hastada gecikmiş kaynama veya kaynamama nedeniyle revizyon yapıldı. Çıkarımlar: Uzun süre (5 yıldan daha uzun) bifosfonat kullanılması, kemik remodelizasyonunun baskılanması ile yakın ilişkili olan artmış kırılganlık nedeniyle yetmezlik kırıklarına yol açabilir. Bifosfonatlar ile atipik düşük enerjili femur cisim kırıkları arasında nedensel bir ilişki henüz gösterilememiş olmakla birlikte bifosfonatların optimal kullanım süresi ve uzun dönem güvenilirliği konusunda endişelerimiz bulunmaktadır. Objective: The aim of this study was to evaluate the demographic characteristics of patients with bilateral bisphosphonate-related low-energy femoral shaft fractures. Methods: The clinical registry was reviewed for patients with bisphosphonate-related low-energy fractures localized at femoral shaft between January 2008 and January 2012. Patients with a diagnosis of postmenopausal osteoporosis, bisphosphonate usage of at least 5 years and prodromal pain prior to fracture were included the study. Results: Five women met the inclusion criteria. All patients had bilateral low-energy sequential femoral shaft fractures. Fracture patterns were similar and atypical (transverse-short oblique fractures with lateral cortical thickening). Mean period of bisphosphonate treatment was 8.6 years. Mean patient age was 76.2 years. Union time of three patients was between 20 and 28 weeks. The remaining two fractures were revised for delayed union or nonunion. Conclusion: Long-term (over 5 years) use of bisphosphonates may cause insufficiency fractures due to increased fragility and brittleness which have a close relationship with depressed bone remodeling. While there is still no causal relationship between bisphosphonates and atypical, low-energy femoral shaft fractures, we have some concerns about the optimal usage time and long-term safety of bisphosphonate drug Daha fazlası Daha az

Birinci, Tansu | Demirbas, Sule Badıllı

Article | 2017 | Acta Orthopaedica et Traumatologica Turcica51 ( 3 ) , pp.233 - 237

Objective: The aim of this study was to analyze the relationship between the medial longitudinal archmobility and static and dynamic balance.Methods: A total of 50 subjects (25 female, and 25 male; Mean age: 22.2 1.3 years; BMI: 22.8 3.8 kg/m2) were included in this study. The relative arch deformity (RAD) was calculated with both 10% and 90%weight bearing (WB). Static balance was evaluated with Single Leg Stance Test and dynamic balance withTechnoBody PK 200WL computerized balance device. Subjects were evaluated for goniometric measurements of lower extremity joints, leg dominance and leg-length discrepancy.Results: Bipedal dynamic . . . balance was correlated with both feet length at 10% WB and 90% WB. Therewas a correlation between the dynamic balance on dominant foot and RAD value on the aspect ofMedium Speed (r¼ 0.32, p ¼ 0.02), Perimeter Length (r ¼ 0.32, p ¼ 0.02) and AnteriorePosteriorSway (r¼ 0.36, p ¼ 0.01). Static balance was unaffected by RAD value when the visual system waseliminated.Conclusion: Our results suggest that decrease of arch mobility on the dominant foot is associated withposterior sway by causing knee or hip strategy and preventing ankle strategy even in small perturbations.The rate of deviation from the equilibrium point and the degree of total swaying increase when arch mobility decreases Daha fazlası Daha az

Atay, E.F. | Güven, M. | Altintaş, F. | Kadioglu, B. | Ceviz, E. | Ipek, S.

Article | 2010 | Acta Orthopaedica et Traumatologica Turcica44 ( 4 ) , pp.306 - 312

Objectives: We aimed to evaluate the effectiveness of postoperative autotransfusion method on prevention of the need of allogeneic blood transfusion in hip and knee arthroplasty. Methods: Seventy-four patients who underwent 77 hip and knee arthroplasty operations were randomized into control and study groups, and evaluated prospectively. In the knee group (39 patients; 30 females, 9 males; mean age 66.6 years), cemented, cruciate retaining, and bicompartmental arthroplasty was performed under tourniquet control; whereas in the hip group (35 patients; 24 females, 11 males; mean age 59.3 years) cementless arthroplasty with posterolate . . .ral approach was performed. None of the patients received preoperative and intraoperative allogeneic blood transfusion. The collected blood in the surgical area was transfused with autotransfusion system to the patients in the study groups at the end of the fourth hour postoperatively. The mean amounts of autotransfused blood in hip and knee groups were 413 mL and 480 mL, respectively. Allogeneic blood transfusion was applied to the patients with hemoglobin level below 8 g/dL, hematocrit level below 25%, and clinical symptoms of anemia. Results: Preoperative and postoperative hemoglobin-hematocrit levels did not differ significantly between study and control groups. Allogeneic blood transfusion was applied to one patient (5%) in study and 8 patients (38%) in control groups during knee arthroplasty (p=0.01); whereas 9 patients (53%) in study and 15 patients (79%) in control groups received allogeneic blood transfusion during hip arthroplasty (p=0.044). The amount of allogeneic blood transfusion in study groups was significantly lower than that in control groups (p=0.008 for knee arthroplasty, p=0.048 for hip arthroplasty). Conclusion: The need and amount of allogeneic transfusion were reduced with postoperative autotransfusion in both knee and hip arthroplasty groups with greater extent in knee arthroplasty. © 2010 Turkish Association of Orthopaedics and Traumatology Daha fazlası Daha az

Bekler, H.I. | Rosenwasser, M.P. | Akilina, Y. | Bulut, G.

Article | 2010 | Acta Orthopaedica et Traumatologica Turcica44 ( 2 ) , pp.157 - 161

Objectives: Autologous interpositional vein grafts are used in peripheral arterial bypass procedures. Sudden exposure of vein grafts to arterial blood pressure is associated with increased wall tension leading to overdistension of the graft and changes in flow patterns. Overdistension of vein grafts often results in anastomotic leaks, thrombosis, and loss of patency. This study was designed to evaluate the use of a biodegradable collagen cover as a means of preventing overdistension of venous bypass grafts in a rat model. Methods: Twenty-two Sprague-Dawley female rats weighing 250-350 g were randomly assigned to two groups: study gr . . .oup (n= 15) and control group (n=7). In all the rats, a 10-mm segment of the left femoral vein was harvested and used as a graft in repair of a right femoral artery injury. Following this procedure, control rats remained untreated. After completion of the femoral artery repair in the study group, the graft was wrapped with a collagen cover of appropriate length (NeuraWrap Nerve Protector) and sutured to form a tube around the vein graft. At the end of the procedure, the intensity and duration of bleeding, and vessel patency were recorded and the proximal and distal arterial segments were examined by Doppler ultrasonography. All observations and measurements were repeated at 1 and 2 hours after surgery. After the second hour, all the rats were sacrificed and vein graft samples with the arterial portions were removed for histological study. Results: After removal of the vascular clamps of the control group, a sudden distension was observed in all the vein grafts. In this group, bleeding at the anastomosis site lasted for 1 to 3 minutes and was followed by ballooning of the grafts. In the study group, however, none of the samples exhibited distension and ballooning. There was no bleeding in 11 samples at all, and bleeding time was less than one minute in the remaining four samples. In the control group, only one graft was patent at two hours, one of the grafts was occluded after only three minutes. In the study group, all the grafts were patent and no thrombosis was noted. The mean blood flow velocity of the control group measured at 0 hour by Doppler ultrasonography was 0.93±0.33 cm/sec in the proximal artery, and 0.73±0.44 cm/sec in the distal artery. The mean blood flow velocities in the proximal and distal arteries of the study group were as follows, respectively: at 0 hour: 0.45±0.27 and 0.46±0.22 cm/sec; at 1 hour: 0.40±0.22 and 0.62±0.40 cm/sec; and at 2 hours: 0.55±0.22 and 0.64±0.37 cm/sec. Conclusion: Prevention of overdistension of vein grafts with the use of an external cover decreases anastomotic leaks, protects the intimal media, maintains blood flow, reduces the incidence of thrombosis, and thus provides a higher patency rate. © 2010 Turkish Association of Orthopaedics and Traumatology Daha fazlası Daha az

Coşkunsu, Dilber | Tunay, Volga Bayrakcı | Akgün, Işık

Article | 2010 | Acta Orthopaedica et Traumatologica Turcica44 ( 6 ) , pp.458 - 463

Amaç: Bu çalışmada Türk ortopedik cerrahlar tarafından yapılan ön çapraz bağ (ÖÇB) tamirinde kullanılan son cerrahi teknikler ve rehabilitasyon protokolleri bildirilerek, sonuçları “ÖÇB Çalışma Grubu” ile karşılaştırıldı. Çalışma planı: Cerrahi yöntemleri, cerrahinin önkoşulları, cerrahi sonrası rutin uygulamalar, rehabilitasyon yaklaşımları ve spora dönüşle ilgili bilgi almak üzere 16 sorudan oluşan bir anket hazırlanarak, yılda 25 ve üzeri ÖÇB tamiri yapan 55 ortopedik cerraha e-posta yolu ile gönderildi. Sonuçlar: Anketin yanıtlanma oranı %70.9 (n39) idi. Ondokuz cerrah (%48.7) sadece hamstring tendon (HT) grefti, dört cerrah (%1 . . .0.3) sadece patellar tendon (PT) grefti, 16 cerrah (%41) hem HT hem de PT grefti kullanmakta idi. Hem HT hem de PT greft kullanan 16 cerrahtan dördünün (%18.8) iki greft tipi için ayrı rehabilitasyon protokolleri vardı. Spesifik aktivitelere başlama zamanları karşılaştırıldığında iki greft tipi için verilen cevaplar arasında istatistiksel olarak anlamlı fark yoktu (p0.05). Rehabilitasyon protokolleri “ÖÇB Çalışma Grubu”nun son verileri ile benzerlik göstermekte idi. Türk cerrahlar ve “ÖÇB Çalışma Grubu” arasında sürekli pasif hareket (continuous passive motion, CPM) cihazı ve postoperatif breys kullanımı açısından fark vardı. Cerrahi sonrası breys ve CPM cihazı kullanımı Türkiye’de daha yaygındı. Çıkarımlar: Türk ortopedik cerrahların HT ve PT greft ile yaptıkları ÖÇB tamirinin cerrahi sonrası yaklaşımı çok az farklılık göstermektedir. Türk ortopedik cerrahlardan elde edilen veriler “ÖÇB Çalışma Grubu” güncel yaklaşımları ile benzerlik göstermektedir. Objectives: This study aims to determine the current approaches to surgical techniques and rehabilitation protocols used in anterior cruciate ligament (ACL) reconstruction performed by Turkish orthopedic surgeons and to compare their results with the data of “ACL Study Group”. Methods: A questionnaire consisting of 16 questions on surgical techniques, preoperative prerequisites, routine postoperative applications, rehabilitation approaches, and return to sport following ACL reconstruction was sent via e-mail to the 55 orthopedic surgeons performing annually 25 or more ACL reconstructions. Results: Response rate to questionnaire was 70.9% (n39). Nineteen surgeons (48.7%) regularly performed only hamstring tendon (HT) graft, and four surgeons (10.3%) performed only patellar tendon (PT) graft, while 16 surgeons (41%) performed both HT and PT grafts. Three (18.8%) of the 16 surgeons who performed both HT and PT grafts had individual rehabilitation protocols for the two graft types. No statistically significant difference was found between the responses for two graft types in terms of the starting times for specific activities (p>0.05). Rehabilitation protocols were similar to the current data of “ACL Study Group”. The use of a postoperative brace and continuous passive motion (CPM) was different between Turkish surgeons and “ACL Study Group”. The CPM and postoperative brace use was more common in Turkey. Conclusion: There are only a few differences in the postoperative approach of ACL reconstruction with HT and PT grafts performed by Turkish orthopedic surgeons. The data obtained from the Turkish orthopedic surgeons showed similarities with the “ACL Study Group” current approache Daha fazlası Daha az

Özler, Turhan | Güven, Melih | Kocadal, Abdurrahman Onur | Uluçay, Çağatay | Beyzadeoğlu, Tahsin | Altıntaş, Faik

Article | 2012 | Acta Orthopaedica et Traumatologica Turcica46 ( 4 ) , pp.237 - 242

Amaç: Çalışmamızda erişkin klavikula orta diafiz kırıklarında açık redüksiyon ve kilitli anatomik plaklarla uygulanan internal tespit yönteminin sonuçlarını ve komplikasyonlarını değerlendirmeyi amaçladık. Çalışma planı: Ayrışmış-parçalı klavikula orta diafiz kırıklarına yönelik açık redüksiyon ve kilitli anatomik plakla tespit uygulanmış en az bir yıl takipli toplam 16 hasta (11 erkek, 5 kadın; ortalama yaş 39.6 yıl) geriye dönük değerlendirildi. Hastaların son takiplerinde erken ve geç dönem komplikasyonları ve Constant ve DASH skorlama sistemine göre fonksiyonel skorları değerlendirildi. Bulgular: Olguların ortalama takip süresi . . .24.6 (dağılım: 12-52) ay, ortalama kaynama süresi 13.3 (dağılım: 10-23) hafta idi. Erken dönemde hiçbir hastanın yara yerinde yüzeysel ve/veya derin enfeksiyon görülmedi ve nörovasküler komplikasyonla karşılaşılmadı. İki (%12.5) hastada implant irritasyonu tespit edildi. Geç dönemde iki (%12.5) hastada implant yetmezliğiyle karşılaşıldı. Bu hastalarda kaynama gecikmesi olduğu düşünülerek 4. ayda daha uzun plakla tespit ve otojen grefonaj uygulandı. Son takiplerde kaynamama ve hatalı kaynama sorunu olan hasta yoktu ve ortalama fonksiyonel skorları Constant skorlamasına göre 85.5, DASH skorlamasına göre 12.8 idi. Constant skorlaması komplikasyonlu hastalarda (p0.007), DASH skorlaması ise komplikasyonsuz hastalarda (p0.001) istatistiksel olarak anlamlı derecede düşük idi. Çıkarımlar: Ayrışmış orta diafiz klavikula kırıklarında kilitli anatomik plaklarla uygulanan tespitlerde komplikasyon oranı düşüktür. Cerrahi sonrası yaşanabilecek komplikasyonlar genellikle implant irritasyonu ve implant yetmezliği ile ilişkilidir. İmplant teknolojisindeki gelişmeler ve yeni implant tasarımlarıyla bu sorunların önüne geçilebilir. Objective: We aimed to evaluate the results and complications of open reduction and internal fixation by locked anatomic plates in adult midshaft clavicular fractures. Methods: Sixteen patients (11 males, 5 females; mean age: 39.6 years) who underwent open reduction and internal fixation with locked anatomic plate for displaced-comminuted midshaft clavicular fractures and were followed-up for at least one year were reviewed retrospectively. Complications in the early and late postoperative periods and functional scores according to the Constant and DASH scoring systems from the latest follow-up were evaluated. Results: Mean follow-up period was 24.6 (range: 12 to 52) months and mean union time was 13.3 (range: 10 to 23) weeks. None of the patients had superficial and/or deep infections in the early postoperative period or neurovascular complications. Two (12.5%) patients had implant irritation. In two (12.5%) patients, implant failure was detected in the late postoperative period. Delayed union was suspected in these patients and they were operated with longer plate and grafting in the 4th month. At the final follow-up, none of the patients had nonunion or malunion and the mean Constant and DASH scores were 85.5 and 12.8, respectively. Constant scores in patients with complications (p0.007) and DASH scores in patients with no complications (p0.001) were significantly lower. Conclusion: Fixation with locked anatomic plates in displaced midshaft clavicular fractures has lower complication rates. Possible postoperative complications are generally associated with implant irritation and failure. These problems can be avoided with the development in implant technology and new implant designs Daha fazlası Daha az

Şaylı, Uğur | Altunok, Elif Çiğdem | Güven, Melih | Akman, Budak | Bıros, Jnev | Şaylı, Ayşe

Article | 2018 | Acta Orthopaedica et Traumatologica Turcica52 ( 3 ) , pp.167 - 173

Objective: This survey was designed to evaluate the prevalence estimations of HV, bunionette, hammertoe as well as their relations to shoe wearing and also familial tendency, in Turkey.Material and Methods: Two thousand six hundred sixty two volunteers (1615 females and 1047 males) with a mean age of 34.15 14.23 (range; 18 to 96) years were asked to answer the predetermined questionnaire between January and June, 2016. Hallux valgus, hammertoe and bunionette images were provided as references and every adult participant without any known forefoot problems or past forefoot surgery history was asked to rate his/her foot and to respond . . . the questions about family history and shoe wearing habits. Responses were statistically analyzed.Results: The prevalence estimations of hallux valgus, bunionette and hammertoe were calculated as 54.3%, 13.8% and 8.9% and positive family history rates were 53.2%, 61.2% and 56.1%, respectively. All three deformities were more common in females than in males (p 0.001). Nonetheless the older age group reported significantly higher prevalence rates for only HV (p 0.001). Likewise, among the three deformities, females reported a higher rate of positive family history only in HV compared to men (p 0.001). Constricting shoe wear was found to affect HV incidence in women (p 0.001) and bun-ionette incidence in both sexes (p 0.01) Daha fazlası Daha az

Inan, M. | Altintaş, F. | Duru, I.

Article | 2009 | Acta Orthopaedica et Traumatologica Turcica43 ( 2 ) , pp.106 - 112

Rotational deformities are common lower extremity abnormalities in children with cerebral palsy, which include intoeing and outtoeing. Intoeing is caused by one of the three types of deformity: increased femoral anteversion, internal tibial torsion, and metatarsus varus, while outtoeing, the less common form, is caused by femoral retroversion and external tibial torsion. An accurate diagnosis should be made with careful physical and radiographic examination. © 2009 Turkish Association of Orthopaedics and Traumatology.